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e <br /> ri RECEIVE SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> eta ENVIRONMENTAL HEALTH DEPARTMENT <br /> ' JUN 0 a 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 /DA <br /> Telephone: (209)468-3420 FaX: (209)464-0138 Web: wfww.sjgov.org/ehd <br /> ENViHCPIiv c iT.hf_ trALi14 % 1 <br /> a>_.T.tealrl o:rr�a PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Yukari Hirayama BUSINESS/AGENCY:Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Shaw road CITY/STATE/ZIP:Stockton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2):818-486-2160 FACSIMILE:209-467-1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 09 June 2015 <br /> Electronic Information: ❑ List❑ ap—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Sveet# Streot Name City -Q"UnIt f <br /> 1. 1404 South Fresno Avenue Stockton IwMP v v,. i -vin <br /> 2. 1405 South Fresno Avenue Stockton LlI V,hc✓J I Lo -1 +9- nit2 <br /> 3. 1524 South Fresno Avenue Stockton `tiST- 40 <br /> 4. 1815 Navy Drive Stockton 6_v- 1 �+^ /unit s <br /> 5. 1541 West Charter Way Stockton ITE MITIGATION <br /> g, Unit 4 <br /> 7. (J/��ltletl ll�)IesWA,Icl) <br /> a, ❑Units <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> A UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY OSOLID WASTE FACILITYIVEHICLE <br /> OTHER CLEANUPSITE(MON•LOP) ❑HOUSING ABATEMENT OWASTE TIRE <br /> (]UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY 0 DAIRY <br /> ©AEOVEGROUND TANK ❑CHICKEN RANCH[DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑E HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPERTRUCKIYARDICHEMICAL TOILETS <br /> Q TIERED PERMITTED FACILITY ❑POOLISPA N LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING X COMPLAINTIREWONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uo to tan addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax en 120)4e4-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recelpt of application- The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ""BOXED AREA-EHD USE ONLY" <br /> U.n[�(riM �� (�hLOn d v1 Pt� 5�[ L91e5 1od IN <br /> ' yb v'u, CD. ofle lArf � P t 1k17S u,A I�Z 1=re"v LC9 N &`h <br /> (J <br /> D deCO p3� Pf S106 s.,d a r - C4 <br /> ❑ Records provided by Staff-PPR Complete, staff Name: <br /> can�a ne 5111n5 <br /> Received Time Jun. 9. 2015 9: 27AM No. 8920 <br />